Biomedical subjects

Asako Nakai

Publications and source records attributed to Asako Nakai.

8 recordsLinked to original sources

PubMed2006

Investigation of uterine peristalsis diurnal variation.

BACKGROUND: In women of reproductive age, wavelike movements of the subendometrial myometrium, which is called uterine peristalsis, is considered to be related with fertility and menstrual problems. This is because the direction and frequency of peristalsis is known to be different among menstrual cycle phases. However, nothing is known as regarding diurnal variations. This study was designed to evaluate for the presence of a diurnal variation in uterine peristalsis. MATERIALS AND METHODS: MR studies were performed on 12 volunteers of reproductive age using a 1.5-T magnet, four times per day (at 0800, 1300, 1800 and 2300 h) during three (periovulatory, luteal and menstrual) phases of one menstrual cycle. Sixty images were obtained by half-Fourier acquisition single-shot turbo spin echo every 2 s and displayed on cine mode. Semiautomated software was utilized to discern the presence of peristaltic waves, as well as peristaltic frequency and direction. The presence of sustained contractions was visually determined. RESULTS: There was no statistically significant difference during the daytime for frequency and direction of uterine peristalsis for all menstrual cycle phases. Nonetheless, peristaltic frequency and direction fluctuated during each cycle. Statistically significant peristaltic suppression was observed in association with sustained contractions during the periovulatory phase. CONCLUSIONS: A diurnal variation was not observed for uterine peristalsis. Sporadic changes in peristaltic frequency were observed and appear to be closely related to sustained uterine contractions.

Adult↗

PubMed2005

Dysmenorrhea: evaluation with cine-mode-display MR imaging--initial experience.

PURPOSE: To prospectively evaluate uterine contractility during menstruation and its relation to primary dysmenorrhea by using magnetic resonance (MR) imaging with cine mode display. MATERIALS AND METHODS: The university ethics committee approved the study protocol, and all subjects gave written informed consent. Nineteen healthy women were examined during menstrual cycle days 1-3 by using a 1.5-T-magnet unit. Sixty serial half-Fourier rapid acquisition with relaxation enhancement MR images of the uterus were obtained every 3 seconds for 3 minutes and displayed in cine mode. MR images were analyzed in terms of thickness of the inner low-signal-intensity myometrial layer, presence of endometrial distortion, and uterine peristalsis detectability. Pain was assessed by using a four-point scale. For 56 MR imaging cases, the association between MR imaging findings and pain degree was examined with Spearman correlation and Mann-Whitney tests. MR imaging findings in the dysmenorrheic and eumenorrheic subject groups were compared by using Mann-Whitney and chi(2) tests. The area of the uterine myometrium in both groups was calculated for quantitative assessment of uterine contraction and was compared between the groups by using the Student t test. RESULTS: MR imaging findings revealed marked changes during cycle days 1-3. Thickness of the inner low-signal-intensity myometrial layer and endometrial distortion were significantly associated with pain degree (P < .001), while uterine peristalsis was undetectable when pain was severe or moderate. The area of the uterine myometrium significantly decreased during cycle days 1-3 in the dysmenorrheic group, as compared with that in the eumenorrheic group (P = .010). CONCLUSION: MR imaging features of the uterus on cycle days 1-3 correlated with pain degree. Cine-mode-display MR imaging is a potential tool for evaluating dysmenorrhea.

Adult↗

PubMed2005

A semiautomated technique for evaluation of uterine peristalsis.

PURPOSE: To evaluate the capability of a newly developed semiautomatic analysis technique for evaluation of uterine peristalsis in comparison with visual assessment. MATERIALS AND METHODS: Cine magnetic resonance (MR) images were obtained from 16 normal volunteers in periovulatory phase. Sixty-eight studies were evaluated by both visual evaluation and by a semiautomated computer assisted software. The software was developed by applying an automated contour tracking method and enables objective analysis of frequency, amplitude, velocity, and direction. Assessments were based on: 1) the recognition of peristalsis, 2) peristaltic direction and frequency, and 3) the way of recognizing peristaltic direction. The data obtained by both modalities were compared with those of previously reported ultrasound (US) findings. RESULTS: Uterine peristalsis was identified in all studies by both objective and visual analyses. There was no significant difference in the identification of peristalsis, recognition of peristaltic directions, or peristaltic frequency (P > 0.05). Data were well in accordance with those in US literature. Peristaltic direction was recognized either by configuration change in the endometrium or by conduction of low signal intensity in the subendometrial myometrium and there was statistically no difference. CONCLUSION: Evaluation of uterine peristalsis by the semiautomatic analysis accorded well with the results obtained visual assessments and previous US findings.

Adult↗

PubMed2005

Oral contraceptives and uterine peristalsis: evaluation with MRI.

PURPOSE: To evaluate the effects of oral contraceptives (OCs) on uterine contractility using cine MRI, and correlate the kinematic findings with the static findings. MATERIALS AND METHODS: Healthy female volunteers of reproductive age (23 taking OCs, and 15 not) were evaluated at mid-cycle. MR images were obtained with a 1.5T magnet, with 60 serial images taken every three seconds by half-Fourier acquisition single-shot turbo spin echo (HASTE) to be displayed in cine mode. Assessments were based on the 1) detectability of uterine peristalsis in cine mode, 2) peristaltic frequency and direction, 3) thickness of the endometrium, myometrium, and junctional zone (JZ) on T2-weighted images (T2WIs), and 4) intensity of the myometrium and cervical mucus on T2WIs and T1-weighted images (T1WIs), respectively. RESULTS: Uterine peristalsis was markedly decreased in the OC users. The endometrium and JZ were significantly thinner, and the myometrium was thicker in the OC users compared to controls. The signal intensity of the myometrium and cervical mucus was significantly higher in the OC users than in controls. CONCLUSION: OCs markedly suppressed uterine peristalsis at mid-cycle, and the uterus displayed a globular configuration with a thin JZ that may be related to decreased uterine peristalsis in OC users.

Adult↗

PubMed2005

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas.

PURPOSE: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. MATERIALS AND METHODS: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. RESULTS: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. CONCLUSIONS: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

Adult↗

PubMed2004

Uterine peristalsis: comparison of transvaginal ultrasound and two different sequences of cine MR imaging.

PURPOSE: To compare uterine peristalsis as seen on two different magnetic resonance (MR) imaging sequences and transvaginal ultrasound (TVUS), so as to better determine the best method for evaluating uterine peristalsis. MATERIALS AND METHODS: Eleven women in the periovulatory phase of the menstrual cycle underwent TVUS and cine MR imaging within a time period of three hours. Findings on cine MR images obtained with a serial 60 half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence and a 300 true fast imaging with steady-state precession (FISP) sequence were compared with TVUS. RESULTS: The image quality of the HASTE technique was the best among the three methods, followed by TVUS, and then true FISP technique (P < 0.001). Uterine peristalsis was detected in 100% of subjects using HASTE, 82% with True FISP, and 100% with TVUS. With HASTE technique, true FISP, and TVUS, respectively, endometrial stripping movement was identified in 100%, 82%, and 100%; direction was identified in 100%, 45% (P = 0.014), and 73%; and wave conduction toward the outer myometrium was identified in 55%, 9% (P = 0.025), and 0% (P = 0.014). CONCLUSION: Cine MR imaging by HASTE technique with a time resolution of two seconds best delineated uterine peristalsis compared to that by true FISP technique or with TVUS.

Adult↗

PubMed2003

Kinematics of the uterus: cine mode MR imaging.

Cine mode magnetic resonance (MR) imaging has allowed evaluation of kinematics of the pelvis. Visualization of dynamic changes under strain facilitates evaluation of prolapses and adhesions between organs. The uterus, an organ of smooth muscle, has an inherent contractility that characterizes it as different from other visceral organs. This sustained contraction has occasionally been shown on static images as a finding masquerading as a leiomyoma or as adenomyosis. Cine mode MR imaging clearly shows the configuration of the myometrium during these dynamic changes, as well as its signal intensity during contractions. Uterine peristalsis, the subtle and rhythmic contractions of the inner myometrium, is also clearly identifiable on cine mode images as a wavy movement of the endometrium and/or inner myometrium. The direction and frequency of uterine peristalsis are different in each of the menstrual cycle phases and are thought to have important roles in uterine function, such as in fertility and menstrual blood discharge. Elucidation of these kinematics of the uterus will help in the evaluation of static MR images and study of the physiology of the uterus. Cine MR imaging is a novel technique for diagnosis and evaluation of the pelvic organs, especially the uterus.

Adult↗

PubMed2003

Uterine peristalsis shown on cine MR imaging using ultrafast sequence.

PURPOSE: To demonstrate and evaluate uterine peristalsis on cine magnetic resonance imaging (MRI) using ultrafast imaging. MATERIALS AND METHODS: Serial MR uterine images (300) were obtained from 15 normal volunteers over four menstrual phases using true fast imaging with steady-state precession (true FISP) technique over 117 seconds and videotaped. Three radiologists independently evaluated videotapes of 59 studies. Uterine peristalsis was defined as wavy movements of subendometrial myometrium or endometrium. Interobserver reliability was evaluated using a Kappa coefficient. Fifty-four studies obtained in appropriate phases were analyzed. RESULTS: Cine MRI displayed uterine peristalsis in 30 of 59 studies; consensus reading showed direction in 23 studies. Reliability between the final consensus of the recognition of uterine peristalsis and those of the three readers was extremely concordant, with a Kappa coefficient of 0.908. Wave direction was cervico-fundal in follicular and periovulatory phases, with frequency of contraction waves being 1.2-2.3 per minute in positive studies. CONCLUSION: Uterine peristalsis was demonstrated on cine MR using ultrafast MRI. Direction and frequency of peristaltic waves are closely related to menstrual cycle phases. Supplementary material for this article can be found on the JMRI website at http://www.interscience.wiley.com/jpages/1053-1807/suppmat/index.html.

Adult↗